Organization
CENTRAL STATE HOSPITAL
Active
Organization
CENTRAL STATE HOSPITAL
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
MARK L REYNOLDS (CONTROLLER)
(502) 253-7135
Entity
Organization
Contact information
Practice address
10510 LAGRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7135
(502) 253-7044
Mailing address
10510 LAGRANGE ROAD, LOUISVILLE, KY 40223-1277
(502) 253-7044
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
100198
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02021293
—
KY
Enumeration date
06/14/2005
Last updated
07/30/2010
Update your record
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